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Introduction: In early operable stages of cervical an endometrial malignancies, surgical staging of lymph nodes is advocated as contrast-enhanced computed tomography (CECT) has limited sensitivity and accuracy. Although fluorine-18 (F-18) fluorodeoxyglucose (FDG)/positron emission tomography (PET)-CT has potential to identify subcentimeter-sized nodal metastases, higher prevalence of pelvic inflammatory disease in developing countries could result in lower accuracy. The present study was undertaken to assess the incremental value of PET scan over CECT for nodal staging before radical surgery. Methods: Forty-four patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IA2-IIb carcinoma cervix and 28 patients of FIGO Stage I-II carcinoma endometrium underwent F-18 FDG-PET-CECT scan. A SUVmax value >2.5 g/ml based on body weight was considered as positive. An enhancing node with >1 cm size in the shortest dimension, with loss of fatty hilum was considered positive on CT images. The histological findings were considered the gold standard against which the two modalities were compared. Results: All 1226 pelvic nodes were dissected, of which 65 were found to be metastatic (i.e., 5.3%). Of the 72 patients, 15 (20.83%) had pelvic nodal metastases. The overall accuracy of PET and CECT for assessment of pelvic nodal metastases was comparable (i.e., 86% vs. 85%). Conclusion: PET and CECT scans have similar accuracy in pelvic nodal staging of operable uterine malignancies. Granulomatous inflammation may not be a major cause of false-positive results. The sensitivity and negative predictive values are not high enough to obviate need of surgical nodal staging. [ABSTRACT FROM AUTHOR]

Sarcomas are a heterogeneous group of rare tumors and arise either from soft tissue or from bone. Soft-tissue sarcomas (STSs) initially metastasize to the lungs. Metastases to extrapulmonary sites such as liver, brain, and soft tissue distant from primary tumor usually develop later. However, cases with isolated adrenal metastasis without disseminated disease have been reported in literature. We present a case of primary myxoid liposarcoma of the lower limb, in which staging 18-F fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) scan detected a suspicious FDG avid adrenal lesion which eventually on resection was diagnosed as asymptomatic pheochromocytoma. Pheochromocytomas have been reported to demonstrate FDG uptake mimicking metastasis. Hence, while interpreting FDG PET-CT scans in the context of STSs, both the extrapulmonary metastatic potential of aggressive histological subtypes of sarcoma and rare possibility of FDG avid coexistent benign tumor should be taken into consideration. [ABSTRACT FROM AUTHOR]

Uptake in non-osseous, non-urologic tissues is occasionally found in the performance of bone scintigraphy. These uptakes reflect an atypical interaction between the radiopharmaceutical and the patient. Knowledge of the rare extraskeletal uptakes and their clinical relevance helps in better interpretation of bone scans. We report an unusual occurrence of extraosseous accumulation of 99mTc-methylene diphosphonate in a phlebolith in bone scan, confirmed with the aid of photon emission computed tomography and computed tomography. [ABSTRACT FROM AUTHOR]

Background: The radiation dosimetric literature concerning the medical and non-medical personnel working in nuclear medicine departments are limited, particularly radiation doses received by radiation worker in nuclear medicine department during positron emission tomography (PET) radiopharmaceutical injection process. This is of interest and concern for the personnel. Aim: To measure the radiation dose received by the staff involved in injection process of Fluorine-18 Fluorodeoxyglucose (FDG). Materials and Methods: The effective whole body doses to the radiation workers involved in injections of 1511 patients over a period of 10 weeks were evaluated using pocket dosimeter. Each patient was injected with 5 MBq/kg of F-18 FDG. The F18-FDG injection protocol followed in our department is as follows. The technologist dispenses the dose to be injected and records the preinjection activity. The nursing staff members then secure an intravenous catheter. The nuclear medicine physicians/ residents inject the dose on a rotation basis in accordance with ALARA principle. After the injection of the tracer, the nursing staff members flush the intravenous catheter. The person who injected the tracer then measures the post-injection residual dose in the syringe. Results: The mean effective whole body doses per injection for the staff were the following: Nurses received 1.44±0.22 μSv/injection (3.71±0.48 nSv/MBq), for doctors the dose values were 2.44±0.25 μSv/injection (6.29±0.49 nSv/MBq) and for technologists the doses were 0.61±0.10 μSv/ injection (1.58±0.21 nSv/MBq). It was seen that the mean effective whole body dose per injection of our positron emission tomography/computed tomography (PET/CT) staff who were involved in the F18-FDG injection process was maximum for doctors (54.34% differential doses), followed by nurses (32.02% differential doses) and technologist (13.64% differential doses). Conclusion: This study confirms that low levels of radiation dose are received by staff during F18-FDG injection and these values can be used as a reference to allay any anxiety in the radiation workers. [ABSTRACT FROM AUTHOR]